Individual provider Active NPI

Martin Alan Rosolinsky, LCSW

  • Clinical Social Worker
  • Bayport, NY
National Provider Identifier
1699831495
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RP014646-1 Issued in NY
Practice address
982 Montauk Highway
Bayport, NY 11705
Phone
(516) 991-6031
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X RP014646-1 NY Primary

Addresses

Primary practice location

982 Montauk Highway
Bayport, NY 11705

Mailing address

15 Ash Dr
Medford, NY 11763-4301
Phone (631) 654-9392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040522000304 NY Practitioner - Clinical Social Worker 6002807500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1959 Monroe Ave
North Bellmore, NY 11710-1520
Phone (516) 826-4891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RP014646-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Guidance Counseling & Licensed Clinical Social Work Services PC Clinical CurrentSince Oct 17, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1699831495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ASH DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634301",
            "telephone_number": "631-654-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 MONTAUK HIGHWAY",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "11705",
            "telephone_number": "516-991-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSOLINSKY",
        "first_name": "MARTIN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RP014646-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayport, NY

Sources for this page

Verify at the official NPI Registry.